Columbia Missourian: Medicaid proposal would change federal funding, give state more control

Jack Morrisroe/Missourian Statehouse Correspondent

JEFFERSON CITY — Republican lawmakers, seeking a way to limit Medicaid costs, are trying to take more state control of how that money is spent in Missouri.

Proposed legislation would ask the federal government to give a lump sum of Medicaid funds to Missouri, rather than paying for each person in the state program. The move would allow the state to have more autonomy in how the money is dispersed.

“This open-ended entitlement has resulted in runaway spending that is bankrupting this state,” said Sen. David Sater, R-Cassville, in a hearing before the Senate Committee on Seniors, Families and Children on Wednesday.

Sater, the bill’s sponsor, and other Republicans said the state needs to control Medicaid costs to fund education and other priorities

Sen. Jill Schupp, D-St. Louis County, said the waiver would mean less federal money for Missourians that Obamacare would have provided.

“We had an opportunity under the Affordable Care Act to expand Medicaid,” Schupp said.

The lump sum would take away Medicaid’s flexibility, said Sidney Watson, a professor at St. Louis University who testified against the bill. Watson said both the federal and state government share rising costs under Missouri’s current system, but the state could take on more risk by asking for a fixed sum.

The bill is not specific on how to control Medicaid spending, but Republicans said health savings accounts, work requirements and more co-payments would be considered.

The committee will consider next steps next week. The bill would ask the state Department of Social Services to request a waiver from the federal government, which could be a lengthy process.

Some lawmakers have said that, under the Obama administration, waivers were more likely to be given in cases of Medicaid expansion. They hope that the Trump administration will be open to issuing waivers to allow more state choice in how money is spent.

Supervising editor is Mark Horvit.

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